| Rene Casanova Medical Office, Inc | |
|
1881 N University Dr Ste 103 Coral Springs FL 33071-8923 | |
| (954) 516-0070 | |
| Not Available |
| Full Name | Rene Casanova Medical Office, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1881 N University Dr Ste 103, Coral Springs, Florida |
| Authorized Official Name and Position | Rene Casanova (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9542025137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rene Casanova Medical Office, Inc 1881 N University Dr Ste 103 Coral Springs FL 33071-8923 Ph: (954) 516-0070 | Rene Casanova Medical Office, Inc 1881 N University Dr Ste 103 Coral Springs FL 33071-8923 Ph: (954) 516-0070 |
| NPI Number | 1629481809 |
|---|---|
| Provider Enumeration Date | 06/05/2014 |
| Last Update Date | 10/18/2023 |
| Medicare PECOS PAC ID | 4284760794 |
|---|---|
| Medicare Enrollment ID | O20100408000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629481809 | NPI | - | NPPES |
| 264910101 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME78770 (Florida) | Primary |
| Provider Name | Rene Casanova |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1689646440 PECOS PAC ID: 7810893724 Enrollment ID: I20031211000318 |
| Provider Name | Zeeshan Mahmood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629119136 PECOS PAC ID: 1759481633 Enrollment ID: I20070706000155 |
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